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Home My WebLink AboutProject Completion Affidavit - Temporary Traffic Calming Materials and Installation Project No 119-053 - Selge Construction Co Inc44 f " �I . "" „ 1316 COUNTY -CITY BUILDING PHONE 574/ 235-9251 227 W. JEFFERSON BOULEVARD��'� FAX 574/ 235-9171 SOUTH BEND_ INDIANA 46601-1830 sw 66 x CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS October 22, 2019 Justin Butler Selge Construction Co., Inc. 1247 Mishawaka Ave. South Bend, In 46615 RE: Project Completion Affidavit — Temporary Traffic Calming Materials & Installation —Project No. 119-053 Dear Mr. Butler: The Board of Public Works, at its meeting held on October 22, 2019, approved the Project Completion Affidavit for this project in the amount of $67,350. A copy of the Project Completion Affidavit is enclosed for your records. If you have any further questions regarding this matter, please call this office at (574) 235- 9251. Sincerely, Linda M. Martin, Clerk Enclosure GARY A. GILOT GENEVIEVE E. MILLER ELIZABETH A. MARADIK LAURA L. O'SULLIVAN THERESE J. DORAU �i�.pk=SYdrp r CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS�i;" PROJECT COMPLETION AFFIDAVIT PROJECT NAME Temporary Traffic Calmin2 Materials & Installation PROJECT NO 119-053 FINAL COST $67,350.00 CONTRACT SIGNED 7/23/2019 MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION Procurement and installation of temporary speed humps and curbing at various locations,. WITNESSETH The work under the above contract between the City of South Bend and the undersigned contractor having been completed, the City of South Bend, its officials and agents are hereby released from all claims and demands whatsoever arising under or by such contract, and that the contractor performed the work within the scope of the Specifications and Standards of the City of South Bend which were a part of the above Contract. Executed this day of _....SJk?e 201 9 Sel a Construction Co., Inc. w - Company Name Signature 2833 S. 11th Street Robert Kuhns Project En ineer Company Address Printed Name Niles, MI 49120 City, State, Zip WITNESSESS: Before me, the undersigned Notary Public in and for said country and state, personally appeared Robert Kuhns and acknowledged his/her signature to the above Project Completion Affidavit on y�o0ll11llf01#eP,, the 1,1rd day of f , 201 S) Notary enature My Commission Expires Vicki A Printed Name County of Residence PUBLI 6 � ��I;w aY4iIV r` LXPIHLS 7 25 2C20 If the Contractor is a corporation, the following certificate will be executed.*,, co, I, Vicki A. Priest , certify that I am Secretary of the Corporation executing this release; Rl�i' tO �� who signed this release on behalf of the contractor was then Pry eot }gin 1 need _ of said Corporation; that said release was duly signed for and on behalf of said Cot ration Authority rity f i governing body, and is within the scope of corporate powers: ° �� Secretary's Signature Corporate Seal Vicki A. Priest Printed Name Berrien DEPARTMENT OF PUBLIC WORKS APPROVAL project I s Is p acceptable foci n approval and we recommend to the Board of Public Works that it be ordained so. Date: Cl. -So. t ot Construction per .• BOARP OF PUBLIC WORKS APPROVAL Date: 1 2 Zc / `7 Gary A Gilot, Presiden Me tier Elizabeth A. Maradik, Member Therese J. Dor6u, Member Il-ora L. O'Sullivan, Member `'°-dyfda M. Martin, Final Waiver of Lien State of Indiana, as: WHEREAS, the undersigned Sel e Construction Co. Inc. has been heretofore employed by the City of South 1lend Indiana to furnish certain material and labor, to wit: Temporary Traffic Calming Materials and Installation NO 119-53 for the real estate owned by the Cif of South Bend located in South Bend, IN County of St. Joseph, State of Indiana, Now Therefore, Know Ye, That the undersigned, for and in consideration of 'T'hree Tlmousand Six Ilundred Sixty Seven, dollars and Fifty Cents 3 307 50I the receipt of which is hereby acknowledged, hereby and now waives and releases unto the said owner of said premises, any and all lien, right of lien or claim of whatsoever kind of character on the above described real estate. TO AND FOR SAID AMOUNT, an account of any and all labor material, or both furnished for or incorporated into said real estate by the undersigned up to this date, and we further certify that the consideration moving to the undersigned for executing this Final Waiver of Lien has been mutually given and accepted as final payment to or on account of the said project for said real estate. Signed, sealed and delivered this 3rd day of October, 2019. Signed Austin Butler Director, Business Operations Personally appeared before me this 3rd day of October, 2019 Justin I3uttgL who, being duly sworn on oath, says: That he is Director, Business Operations of the Sel ge Construction (::o, Inc. and that he hereby acknowledges the execution of t1he foregoing instrument for and on behalf of said Set e Construction. Co., Itac, i, µ": 2 2 P R My Commission expires: 0/ 5/20 0 Notary Public'"'° ore � Q BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 10/14/2019 �._.. _...._.._._.................................................................................. _ Name Toy Villa Department Engineering BPW Date 10/22/2019 Phone Extension 5920 W qIT IT ITITIT Submittal to Board . mm Re used Prior to Subm� BPW Attorney Attorney Name _._ ___._. Dept. Attorney ❑ Attorney Name Purchasing ❑ ....... Check the r)bronr ❑ Professional Services Agreement E] Contract ❑ Open Market Contract ❑ Amendment/Addendum ❑ Bid Opening Bid Award Quote Opening ❑ Quote Award Proposal Opening C/O & PCA No. Chg. Order, No. ❑ Traffic Control Other: Required Informati Company or Vendor Name SelgemConstruction Co., Inc. New Vendor MBE/WBE Contractor Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description o All Submissions mm Proposal El Special Purchase, QPA Req. to Advertise ❑ Title Shee Reject Bids/Quotes ® PCA E] Resolution Ease./Encroach U YesU If Yes, Approved by Purchasing No ❑ MBE Completed E-Verify Form Attached Yes ❑ WBE No Temoorary Traffic Calming Materials & Installation _.................. 119-053 LRSA Capital�666��..........._.....� 2 51mm. 0608.431.42.96 Project Closeout ........ For "huge Orders Only ._ _ _ .. ...-....... Amount of Increase $ ._ .....�.. -------------------------------------------------- Decrease �$..................._.._._ Previous Amount $ Increase % Current Percent of Change: Decrease % New Amount $ Increase % Total Percent of Change: Decrease ( %) �mmmmm._._._. ITmmmmmmmmm Time Extension Amount: New Completion Date: